Associated Diseases in Inpatients with Dementia

OBJECTIVES: Patients with dementia are accompanied with poor autonomy and multiple disability. Therefore moer cost and medical service are required than non-dementia patients. In order to insure comprehensive, systematic care for dementia patients, knowledge of the associated disease of different types of dementia is warranted. This study evaluate the characteristics of associated disease in inpatients with dementia, to be used as basic reference for effective treatment. METHODS: The study popultion consist of 92 patients with dementia admitted between January 1, 1996 and September 30, 1997 to geriatric department, Yosei University Kwangju Severance Psychiatric Hospital. Diagnoses were based on DSM-IV and NINCDS. Severity of dementia was evaluated by GDS (Global Deterioration Scale). Associated diseases was recorded in separated checklist. chi-test, Fisher's exact test, ANOVA, T-test, Wilcoxon rank sum test, Kruskal-Wallis test were used to determine statistical differences among the dementia subgroup. RESULTS: The mean age was 71.8+/-9.2 with 31 male (33.7%) subjects and 61 female subject (66.3%). The types of dementia among the 92 demented patients were as follows:50 (54%) with Alzheimer's disease, 30 (33%) with vascular dementia, 12 (13%) with unclassified dementia. Mean GDS score was 5.4+/-1.1. The mean duration of admission was 66.9+/-88.9 days. Types of discharge were normal discharge 33 (35.9%), discharge against doctors' advice 28 (30.4%), transfer 23 (25.0%). The average number of diagnoses was 4.9+/-2.4. (4.5+/-2.4 in Alzheimer's disease, 6.1+/-2.4 in vascular dementia, 5.3+/-2.1 in unclassified dementia in respectively (p<0.05). The most common associated disease were gastrointestinal disorders (24.8%), cardiovascular disorders (11.8%), urinary tract infection (6.8%), musculoskeletal disorder (6.6%), diabetes mellitus (4.5%). Associated diseases that their frequency showed significant differences in different types of dementia were hypertension, diabetes mellitus, urinary incontinence, oral cavity disease, anemia (p<0.01). CONCLUSIONS: Associated disease are different in different type of dementia. Patients with vascular dementia had more associated disease and received more drugs for associated disease than Alzheimer's disease. Our data emphasize comprehensive and systematic treatment plan according to type of dementia.

Factors related to depression of elderly in a Korean rural community

BACKGROUND: Depression is prevalent and a serious disorder in the elderly that interferes with social and physical function. It is associated with significant morbidity and a high mortality rate from suicide. Depression is highly treatable disease, but it remain largely unrecognized and untreated among the elderly. This study evaluate the factors related to depression of elderly, to be used as basic reference for management program in the community. METHODS: The cross-sectional study evaluates the depression of community-living elderly, aged 60 and older, in a Korean rural community. The subject were selected from a two stage cluster sampling. Questionnaire contained demographics, Geriatric Depression Scale (GDS), Mini-Nutritional Assessment (MNA), Mini-Mental Status Exam-Korean (MMSE-K), IADL, Social support network. T-test and multiple stepwise regression were constructed to explore the factors related to depression. RESULTS: Mean age was 71.22+/-7.1 with 101 male subjects and 200 female subjects. The mean GDS score was 6.9+/-3.7 and 56.5% of subjects were suggested depression (above 5 point on GDS). The mean score from the GDS showed significant differences in terms of following factors: gender, age, education, marital status, income, expenditures, type of residency, cognitive function, presence of disease, number of medications, stress, subjective self perception of health, IADL, nutrition, emotional support, social activity support, instrumental support (p0.05). These variables explained 34.2% of depression. CONCLUSION: Nutritional status, cognitive function, physical state, functional state, social support network demographic characteristics were related to depression in the elderly.

Factors Related to Nutritional Status of Elderly in a Korean Rural Commuity

BACKGROUND: Nutrition is closely related to morbidity and mortality, and active intervention is known to be effective in their prevention. This study evaluates the factors related to nutritional status of elderly, to be used as a basic reference for effective prevention program. METHODS: The cross-sectional study evaluates the nutritional status of community-living elderly, aged 60 and older, in a Korean rural community. The subject were selected from a two stage cluster sampling. Questionnaire contained demographics, the Mini-Nutritional Assessment(MNA), Mini-Mental Status Exam-Korean(MMSE-K), Geriatric Depression Scale(GDS), IADL, Social support network, and dietary patters. T-test and hierarchical regression models were constructed to explore the factors related to nutritional status. RESULTS: Mean age was 72+/-7.1 with 101 male subjects and 200 female subject. The MNA score revealed 41.5% of subjects who were at risk of malnutrition. The mean MNA score showed significant differences in terms of following factors: gender, age, education, marital status, income, expenditures, MMSE-K, GDS, social support, instrumental support, regularity of meal, changes in taste, satisfaction in food, unbalanced dietary habit, number of family members sharing the meal, IADL, presence of disease, number of medications(p<0.05). Multiple regression analysis revealed that demographic characteristics explained 7.5% of nutritional status, social support network 6.7%, mental disease 25.3%, dietary pattern 23.8% , and physical disease 22.2% correspondingly. Whole model explained 45.1% of nutritional status. The significant variables were the number of medications, presence of stress, unbalanced dietary habit, regularity of meal, instrumental support, depression, cognition, and satisfaction in food(p<0.05). CONCLUSION: Mental and physical state, dietary pattern, social support network, demographic characteristics were related to nutritional status.